Editors' Note: Systolic Blood Pressure Postural Changes Variability is Associated With Greater Dementia Risk

In “Systolic Blood Pressure Postural Changes Variability is Associated With Greater Dementia Risk,” Rouch et al. reported that systolic orthostatic hypotension (OHYPO, defined as a fall of ≥15 mm Hg in systolic blood pressure after standing from a sitting position on ≥1/3 visits) and visit-to-visit systolic blood pressure postural changes variability were associated with an increased risk of dementia. There was no association between diastolic OHYPO (a fall of ≥7 mm Hg in diastolic blood pressure) and risk of dementia. Soysal noted that the criteria used differed from those published by the 1996 Consensus Committee of the American Autonomic Society and American Academy of Neurology, which defined OHYPO as a fall of ≥20 mm Hg in systolic blood pressure and/or ≥10 mm Hg in diastolic blood pressure. Soysal further pointed out that systolic OHYPO is associated with frailty, fear of falling, malnutrition, and sarcopenia, all of which are associated with dementia. Rouch et al. responded that they did not use the criteria Soysal cited because they are applicable to the transition from supine-to-standing, which is more hazardous than standing from a sitting position. Instead, they selected their thresholds based on previous large studies and recent literature that these values were associated with 80% sensitivity and 89% specificity.